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Benefits and Risks Associated With Antibiotic Prophylaxis for Thyroid Operations.

Samuel D Squires1, Robin M Cisco2, Dana T Lin2

  • 1Brigham Young University, Provo, Utah.

The Journal of Surgical Research
|August 21, 2024
PubMed
Summary

Prophylactic antibiotics (pABX) are often given before thyroid surgery, but this study found no link to fewer surgical site infections (SSI). Deimplementing routine pABX in thyroidectomy may be beneficial.

Keywords:
Antibiotic prophylaxisSurgical site infectionThyroidectomy

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Area of Science:

  • Surgical oncology
  • Infectious disease prevention
  • Clinical outcomes research

Background:

  • Prophylactic antibiotics (pABX) are frequently administered before thyroid surgery, despite the procedure being classified as clean.
  • The necessity and efficacy of pABX in thyroidectomy remain subjects of investigation.

Purpose of the Study:

  • To evaluate the association between prophylactic antibiotic use and the incidence of surgical site infections (SSI) in patients undergoing thyroidectomy.

Main Methods:

  • A cohort study included adult patients undergoing thyroid operations between 2010 and 2019.
  • Propensity score matching was used to control for patient demographics and comorbidities influencing SSI risk.
  • The primary outcome was 30-day SSI, identified through diagnosis codes and/or antibiotic use.

Main Results:

  • Of 2411 patients, 56.3% received pABX, often with higher comorbidity scores.
  • Unadjusted SSI incidence was higher in the pABX group (6.1% vs. 3.4%).
  • After propensity score matching, pABX use was not associated with a reduced risk of overall 30-day SSI or SSI requiring intervention.

Conclusions:

  • Prophylactic antibiotic use was not associated with a decreased incidence of SSI in a large, comorbid cohort undergoing thyroid surgery.
  • These findings suggest that routine pABX may be low-value in thyroidectomy.
  • Deimplementation of prophylactic antibiotics in thyroid surgery should be considered to optimize patient care and resource allocation.